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Cholesterol Fact Sheet

1.  Source:  Heart Healthy Eating:  Cholesterol, Fat, Fiber, and Sodium,  Virginia Tech Extension Service, Authors: Kathleen M. Stadler, Extension Specialist, and Forrest W. Thye, Associate Professor, Human Nutrition, Foods, and Exercise, Virginia Tech;   Publication Number 348-898, August 1996.  Visit their web site for tables.

Introduction

Everyone wants to be healthy. (Wealthy and wise, too!) What you eat and do can help you to stay healthy. In recent years, there has been much emphasis on changing one's diet to reduce the risk of heart disease and cancer, as these two diseases are the major causes of death in this country.

How to prevent and how to detect these diseases in the early stages while they are treatable are major areas of study. Too often, the first symptom of heart disease is a fatal heart attack or stroke. Imagine the excitement of doctors when they found that a high level of cholesterol in the blood was often associated with heart disease. The cholesterol content of the blood can be measured by a simple blood test and can usually be lowered by making dietary and lifestyle changes-no expensive tests or surgery required; not even medicine for most persons.

Many of the dietary changes that help to reduce one's risk of heart disease also appear to reduce risk of cancer. This publication offers suggestions on how to make those dietary changes.

A Cholesterol Review

Cholesterol is a fatty substance which is carried by the blood to all parts of the body. It can also be manufactured by most cells of the body. Some of the cholesterol comes from food, but the majority is made by your body. If there is too much cholesterol, there's a chance that some will collect in the walls of the blood vessels and, in time, even clog the blood vessels. If that should happen, you might have a heart attack or stroke.

In addition to knowing the total amount of cholesterol in your blood, the doctor finds it helpful to know how much of the cholesterol is present as HDL-cholesterol (the good kind) and as LDL-cholesterol (the bad kind). Cholesterol teams up with protein to get through the blood vessels. HDL, a high density lipoprotein made up of lipid (another word for fat) and protein, has more protein than fat and appears to carry the cholesterol it contains to the liver for excretion out of the body. HDL-cholesterol is known as the "good" cholesterol. Therefore, you want a high HDL number because that indicates a high level of this good cholesterol in your blood. It is desirable to have a HDL-cholesterol of more than 35 mg/dl. An average HDL number is in the mid-forties range for a man and in the fifties range for a woman. A HDL number less than 35 is considered a risk factor. For more information on coronary heart disease risk factors and cholesterol numbers, refer to VCE Publication  348-018, Know Your Cholesterol Number .

LDL is a low density lipoprotein (more fat, less protein). The cholesterol it contains is carried to the tissues and may be deposited in the blood vessels, which causes plaque formation. It is desirable to have a LDL-cholesterol of less than 130 mg/dl. The LDL number is always larger than the HDL number.

Cholesterol Levels

2.  Source: National Institute of Health web site

Step by Step: Chapter 2 Get Set...
What You Need to Do to Lower Blood Cholesterol

Go to:
What Can You Do to Lower Your Blood Cholesterol Level?
A Look at Your Way of Eating
Heart-Healthy Eating: The Step I and Step II Diets
A Word About Sodium
What Kind of Success Can You Expect?

What Can You Do to Lower Your Blood Cholesterol Level?

Now that you know about blood cholesterol, get set to lower it. All healthy
Americans, regardless of their blood cholesterol level, should eat in a
heart-healthy way. This is true beginning with toddlers (about age 2) on up to
their parents, grandparents, and even great-grandparents. The whole family
should also be physically active. And if you have a high blood cholesterol
level -- whether due to what you eat, heredity, or both -- it is even more
important to eat healthfully and to be physically active. Adopting these
behaviors also can help control high blood pressure as well as diabetes.
You'll find more help on heart-healthy eating and physical activity a little
later in this resource.

First, here are some general rules to lower blood cholesterol:

1. Choose foods that are low in saturated fat.

All foods that contain fat are made up of a mixture of saturated and unsaturated fats. Saturated fat raises your blood cholesterol level more than anything else that you eat. It is found in the greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils like coconut, palm kernel, and palm oils. The best way to reduce your blood cholesterol level is to choose foods low in saturated fat. One way to do this is by choosing foods such as fruit, vegetables, and whole grain foods naturally low in fat and high in starch and fiber.

2. Choose foods that are low in total fat.

Since many foods high in total fat are also high in saturated fat, eating foods low in total fat will help you eat less saturated fat. When you do eat fat, you should substitute unsaturated fat for saturated fat. Unsaturated fat is usually liquid at room temperature and can be either monounsaturated or polyunsaturated. Examples of foods high in monounsaturated fat are olive and canola oils, those high in polyunsaturated fat include safflower, sunflower, corn, and soybean oils. Any type of fat is a rich source of calories, so eating foods low in fat will also help you eat fewer calories. Eating fewer calories can help you lose weight -- and, if you are overweight, losing weight is an important part of lowering your blood cholesterol.

3. Choose foods high in starch and fiber.

Foods high in starch and fiber are excellent substitutes for foods high in saturated fat. These foods -- breads, cereals, pasta, grains, fruits, and
vegetables -- are low in saturated fat and cholesterol. They are also usually lower in calories than foods that are high in fat. Foods high in starch and fiber are also good sources of vitamins and minerals. Diets low in saturated fat and cholesterol, and high in fruits, vegetables, and grain products -- like oat and barley bran and dry peas and beans -- may help to lower blood cholesterol.

4. Choose foods low in cholesterol.

Dietary cholesterol also can raise your blood cholesterol level, although usually not as much as saturated fat. So, it is important to choose foods low in dietary cholesterol. Dietary cholesterol is found only in foods that come from animals. Many of these foods also are high in saturated fat. Foods from plant sources do not have cholesterol but can contain saturated fat.

5. Move it... Be more physically active.

Moving it -- being physically active -- helps your blood cholesterol levels; it can raise HDL and may lower LDL. Being more active can also help you lose weight, lower your blood pressure, improve the fitness of your heart and blood vessels, and reduce stress.

6. Lose weight, if you are overweight.
People who are overweight tend to have higher blood cholesterol levels than
people of desirable weight. And overweight people with an "apple" shape --
bigger (pot) belly -- tend to have a higher risk for heart disease than
those with a "pear" shape -- bigger hips and thighs.


Whatever your body shape, when you cut the fat in your diet, you cut down on
the richest source of calories. An eating pattern high in starch and fiber
instead of fat is a good way to lose weight: many starchy foods have little
fat and are lower in calories than high fat foods. If you are overweight,
losing even a little weight can help to lower LDL-cholesterol and raise
HDL-cholesterol. You don't need to reach your desired weight to see a change
in your blood cholesterol levels.


To lower your blood cholesterol, remember to:

Choose foods low in saturated fat and cholesterol;
Be more physically active; and
Lose weight, if you are overweight.

A Look at Your Way of Eating

Take a minute to look at your current way of eating. "MEDFICTS" is a checklist of foods for you to fill out. Don't worry, it's not a test. Foods from each of the various food groups are listed in two groups, Group 1 and Group 2. The number of servings eaten each week is listed in the "Weekly Consumption" column, and the size of the servings is listed in the "Serving Size" column. Think about the foods you eat each week. Look at each food category -- are the foods you eat listed under Group 1 or Group 2? Once you know the group, follow the line over to the circles under "Weekly Consumption." Check the circle that best describes the number of servings of those foods you usually eat in one week. Then check the circle for the portion size you usually eat. Do the same thing for each of the food groups. Check your score on the bottom of page 11. It will show you whether you are following the Step I or Step II diet, or whether you need to make some further changes. If you need help with MEDFICTS, bring it with you the next time you visit your doctor.
Access MEDFICTS
Note: MEDFICTS is a large HTML file consisting of 6 large graphics; it may
take several minutes to load.

Heart-Healthy Eating: The Step I and Step II Diets [Mayo Clinic]

All Americans should follow the general rules to lower blood cholesterol. In fact, this is a way that the whole family can eat (except infants under 2 years who need more calories from fat), because these guidelines are similar to those recommended for the general population. And if the whole family eats in this way, it will help you make your blood cholesterol-lowering diet your everyday way of eating.

If you have high blood cholesterol, you will have to pay attention to what you eat by following either the Step I diet or Step II diet, as advised by your doctor.

Step I Diet

On the Step I diet, you should eat:

8-10 percent of the day's total calories from saturated fat.
30 percent or less of the day's total calories from fat.
Less than 300 milligrams of dietary cholesterol a day.
Just enough calories to achieve and maintain a healthy weight. (You may want to ask your doctor or registered dietitian what is a reasonable calorie level for you.)

If you do not lower your blood cholesterol enough on the Step I diet or if you are at high risk for heart disease, your doctor will ask you to follow the Step II diet. If you already have heart disease, you should start on the Step II diet right away. The Step II diet helps you cut down on saturated fat and cholesterol even more than the Step I diet. This helps lower your blood cholesterol even more.

Step II Diet

On the Step II diet, you should eat:

Less than 7 percent of the day's total calories from saturated fat.
30 percent or less of the day's total calories from fat.
Less than 200 milligrams of dietary cholesterol a day.
Just enough calories to achieve and maintain a healthy weight. (You may want to ask your doctor or registered dietitian what is a reasonable calorie level for you.)


The recommendations for saturated fat and total fat are based on a percentage
of the calories you eat; the actual amount you should eat daily will vary
depending on how many calories you eat. See the chart below to get an idea of
the number of grams of saturated fat and total fat you should be eating.
Counting Saturated Fat and Total Fat on the Step I & Step II Diets

   

If you eat this many calories...   1,200             1,500           1,800            2,000             2,500

Your recommended amount of
   saturated fat (grams)* for
    each day is...
                                  Step I           12                   15                18                 20                    25
                                  Step II         8-10                12                 12                13                    17                                                                     

Your recommended total
amount of fat (grams)**
for each day is...
                   Step I and Step II      40                    50                 60                 65                  80

*Amounts are equal to 9% of total calories for Step I and 6% of total calories for Step II.
Remember 1 gram of fat equals 9 calories.
**Amounts are equal to 30% of total calories (rounded down to the nearest five);
your intake should be this amount or less.

To get the full benefits of the Step II diet, you should have help from a registered dietitian or other qualified nutritionist. To find a registered
dietitian, contact:

The National Center for Nutrition and Dietetics' Consumer Nutrition Hotline at 1-800-366-1655, Your local hospital and/or public health department, or Your doctor.

If your levels do not go down enough, you may need to take medicine along with
your diet.


A Word About Sodium
If you have high blood pressure as well as high blood cholesterol (and many
people do), your doctor may tell you to cut down on sodium or salt. As long as
you are working on getting your blood cholesterol number down, this is a good
time to work on your blood pressure, too. Try to limit your sodium intake to
2,400 milligrams a day. We'll give you tips on how to do this later.
For more detailed sodium information on specific foods, refer to the table
listing the "Sodium Content of Heart-Healthy Foods" and to the tables on food
and food groups.

What Kind of Success Can You Expect?
Generally your blood cholesterol level should begin to drop a few weeks after
you start on a cholesterol-lowering diet. How much your level drops depends on
the amounts of saturated fat and cholesterol you used to eat, how high your
high blood cholesterol is, how much weight you lose if you are overweight, and
how your body responds to the changes you make. Over time, you may reduce your
blood cholesterol level by 10-50 mg/dL or even more.